Utilisation of Health Information System (HIS) in Namibia: Challenges and Opportunities Faced by the Health Care Delivery System/Health Sector

Dr L Haoses-Gorases, Faculty of Medical and Health Sciences, University of Namibia

The National Health Information System (NHIS) falls under the Primary Care Directorate, Ministry of Health and Social Services (MoHSS). It was established after Namibian independence in 1990 and is charged with the responsibility of providing a comprehensive source of data on a large number of health related indicators. NHIS was designed to improve service delivery terms of quality and effectiveness of strategies and to monitor the trends in disease occurrence. In addition, it also provides information for national policy makers, socio-economic and health personnel, as well as the public at large.

Scaling up of HIV/AIDS, Malaria and Tuberculosis: Expanded strategies to address these public health priorities have created an intense need for the improvement and upgrading of the NHIS.

The organisational structure of the NHIS system is fragmented across different directorates and institutions. The Management Information System is housed in the Directorate of Planning and Human Resources, MoHSS, which collects data on human resources, health infrastructure, and logistics. However, NHIS is managed by the Primary Health Care Directorate, which collects statistics from the health facilities. The challenges to the system are that there is a shortage of human resources to coordinate, analyse, and report on the information in a comprehensive and timely fashion.

The Central Bureau of Statistics (CBS) falls under the National Planning Commission (NPC). The role of the CBS is the implementation of census, household surveys, and analysis of vital events. The information is used for planning, resource allocation, and redirecting of the Mid-Decade Goals, Vision 2030, and the National Development Plans. Despite gaps and shortcomings, there has been a marked improvement in the quality of information provided.

Challenges to the system are numerous. Since its inception, the HIS has undergone revolutionary stages. This paper is based on the shortfalls that are continuously identified, which are directly or indirectly connected to the following:

·  Lack of skilled health workers at different levels

·  Shortage of human capital at national level to spearhead the process

·  Absence of a regulatory and legal framework, making it difficult to obtain data from private and other stakeholders

·  Fragmentation of information across different units

·  Development partners generating parallel systems which are not compatible with existing systems

·  Feedback mechanism between national level and facility levels poor or not satisfactory

·  Data available, but health workers are not utilising the information for planning, day-to-day activities, and development of policies and guidelines.

The recommendations are as follows:

·  Establishment of a co-ordinating mechanism that brings together all key role players in health information

·  Development of a National Health Information Plan in line with (HMN) framework

·  Provision of skilled health workers in NHIS at national level, e.g. Epidemiologists, Statisticians, etc

·  Development of a critical mass database

·  Extensive training in utilisation of health biomedical information

·  Mobilise resources to address shortcomings in the proper establishment and integration of systems

·  Development of an integrated data based (data warehouse) in the Ministry of Health

In conclusion, the upgrading of a sound NHIS will lead to sustainable development support for the “Health for all goals in the short as well as the long term”.